74808D - Luu

CAMA / DREDGE & FILL NO. 74808 A B C j
GENERAL PERMIT Previous permit #
I
z4New � Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ". ]ozcv
�- ❑Rules attached.
Applicant Name I riq h Lliq L Pr�oje�c/t Location: CountyA/P /�1�1
Address 9 M LJ/� 4� CWV,6 Qqd J CT rStr/eet',dAss/ State Road/ Lot #(s)
City 1 State" zip a840'f `>47o C`01_55401d5 1,yev
Phone # (710) Qq E-Mail 7r' ^ A • 1 uu @ w- 4" Subdivision
Authorized Agent City l fipk) lU ' ` zip
Affected ❑ Cw Ew J$PTA ❑ ES ❑ PTS Phone # ( ••}� River Basin c r%
AEC s : ElOEA C HHF ❑ IH UBA [I N/A Wtr. Body
y �1/l'U na man /unkn)
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ORW: ye l / no PNA e1 / no Closest Maj. Wtr. Body AlW V
Type of Project/ Activity
P_2 f�
Pier (dock) length
Fixed Platformolbxg, lbX9
Floating Platform( )
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore —
Basin, channel --
cubic yards
Boat ramp
Boathouse/ Boatlift
s
Beach Bulldozing
Other �--
r
Shoreline Length
SAV: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions Idaaa
/0 l/,.tlll -_e-k,G P 12,
Jr-fnh LW _
Agent or Applicant rinted Name
Signature * Please read compliance statement on back of permit"
Application Fee(s) Check #
t /C
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(Scale: (Vr s
it
❑ See note on back regarding River Basin rules.
pe�rmit's0
ignature
2 /►ti/aoaa 6 1I A09,0
Issuing Date Expiration Date

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
(Lot or Street , Street or Road, City & County)
Agent's Name #: Mailing Address:
Agent's phone #:
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
G-A I do not wish to waive the 15' setback requirement.
(Property ::n
mation)
Signatu e
Luc
Print or Type Name
1/71 L C✓O.rSWj nW Ni ✓e,
Mailing Address
NC
City/StatelZi
Telephone Number
Date
(Adjacent Property Owner, Information)
Signature
Print or Type Name
J-t' � t^�ou�lj�c5�� 4-Al
Mailing Address
W1 L-M1,J6 /JC- 2V"
City/StatelZip
( 910)
Telephone Number
,V8/z�
Date
Revised 6/18/2012

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,I!! zli i•Z s
(Name of Property Owner)
property located at r ��- 6 q, U I
(Addr ss, Lot, BI c , Road, etc.)
on Lr�� �w �� ( fir. �cf�ti , in I ", . , N.C.
(Waterbody) (City/Tow and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to waive
the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
f� ✓ I do not wish to waive the 15' setback requirement.
(Property O er Information) (Adjac t Property Owner Information)
�—
SignatW,ei atur
Print or Type Nc1me Print or Type Name
w/ i- C; �f�w,v�c�r /)i, vc,
Mailing AddreMeiling Address
s
City/State p _ City/State/Zi F
r�l�,
Telephone Number Telephone I*mber
Date Date
(Revised 611812012)

Tue Jan 28
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of ^ 61
7

Deb Racal W
D ft DWOSIMd
Check Frorn —
Name of Permit Holder
Vend-
Check Number
Check
amount
Permit Numbe /Comments
Receipt -Ref—&Reallocated
Cowmnl
Cok~2
Column8
Column!
Co1umn8
CokmaS
Column?
Column8
Column9
2/18/2020
Bude Smith Money Order
Robert Thacker, Jr._
same
BancFirst
162818944
$ 200.00
GP #74865D
GP #74808D
JD rcL 10829
2/18/2020
Trinh Thanh Luu
Charles Schwab Bank
1366
200.00
PA rct. 9736